A survey of Patients and staff satisfaction with a Rapid Response Psychiatric Liaison Service in an Acute Hospital: Are Elderly Patients Easier to please?

Background and Objectives:The provision and quality of mental health services in Acute General Hospitals is a growing concern. Developing research to elicit the views of patients and staff will offer insights into service improvements. The Rapid Assessment, Interface and Discharge service (RAID) developed in an Acute General Hospital to deliver a rapid-response, 24-hour, 7-day- a- week, age-inclusive intervention was evaluated for its impact on staff satisfaction, with emphasis on staff training; and patient satisfaction, with emphasis on the differences in satisfaction between working age (under 65 years) and older adults (over 65 years).Population:Staff working in acute hospital for patients with mental health needs, and patients presenting to acute hospitals, requiring clinical input for their mental health.Method:Data on patient satisfaction was collected through a structured telephone questionnaire including fixed and open-ended questions. Data related to staff satisfaction regarding the service provided was collected by a semi-structured interview administered face-to-face with staff from wards referring to the team. Training was evaluated using open-ended, Likert-scale and open-ended questionnaires.Results:Results show that the majority of working age patients rated the service as ‘good’ (42.2%), felt that the team was helpful in their care (84.8%), met their mental health needs (69.7%), and treated them with respect (96.1%). Overall, older adults rated the service as ‘excellent’ (58.3%), felt that the team was helpful in their care (85.7%), met their mental health needs (85.7%), treated them with respect (92.9%) and stated that they were seen in good time (100%). The difference in satisfaction levels between patients of working age and older patients was statistically significant.Common aspects staff rated as most helpful were advice on managing patients (12.0%), support of staff (11.0%) and advice on medication (11.0%). The majority of staff surveyed felt that their practice would be improved following the training, and rated it as either excellent (61.6%) or good (36.3%).Interpretation and Conclusion:This study highlighted the benefits of providing support and training to staff working directly with patients with mental health needs. It is more challenging to measure the satisfactory effect of older people who continue to give favourable answers on satisfaction questionnaires

A survey of Patients and staff satisfaction with a Rapid Response Psychiatric Liaison Service in an Acute Hospital: Are Elderly Patients Easier to please?

Background and Objectives: The provision and quality of mental health services in Acute General Hospitals is a growing concern. Developing research to elicit the views of patients and staff will offer insights into service improvements.  The Rapid Assessment, Interface and Discharge service (RAID) developed in an Acute General Hospital to deliver a rapid-response, 24-hour, 7-day- a- week, age-inclusive intervention was evaluated for its impact on staff satisfaction, with emphasis on staff training; and patient satisfaction, with emphasis on the differences in satisfaction between working age (under 65 years) and older adults (over 65 years). Population: Staff working in acute hospital for patients with mental health needs, and patients presenting to acute hospitals, requiring clinical input for their mental health. Method: Data on patient satisfaction was collected through a structured telephone questionnaire including fixed and open-ended questions.  Data related to staff satisfaction regarding the service provided was collected by a semi-structured interview administered face-to-face with staff from wards referring to the team.  Training was evaluated using open-ended, Likert-scale and open-ended questionnaires. Results: Results show that the majority of working age patients rated the service as ‘good’ (42.2%), felt that the team was helpful in their care (84.8%), met their mental health needs (69.7%), and treated them with respect (96.1%). Overall, older adults rated the service as ‘excellent’ (58.3%), felt that the team was helpful in their care (85.7%), met their mental health needs (85.7%), treated them with respect (92.9%) and stated that they were seen in good time (100%). The difference in satisfaction levels between patients of working age and older patients was statistically significant. Common aspects staff rated as most helpful were advice on managing patients (12.0%), support of staff (11.0%) and advice on medication (11.0%). The majority of staff surveyed felt that their practice would be improved following the training, and rated it as either excellent (61.6%) or good (36.3%). Interpretation and Conclusion: This study highlighted the benefits of providing support and training to staff working directly with patients with mental health needs.  It is more challenging to measure the satisfactory effect of older people who continue to give favourable answers on satisfaction questionnaires

On the Temporal Effects of Mobile Blockers in Urban Millimeter-Wave Cellular Scenarios

Millimeter-wave (mmWave) propagation is known to be severely affected by the blockage of the line-of-sight (LoS) path. In contrast to microwave systems, at shorter mmWave wavelengths such blockage can be caused by human bodies, where their mobility within environment makes wireless channel alternate between the blocked and non-blocked LoS states. Following the recent 3GPP requirements on modeling the dynamic blockage as well as the temporal consistency of the channel at mmWave frequencies, in this paper a new model for predicting the state of a user in the presence of mobile blockers for representative 3GPP scenarios is developed: urban micro cell (UMi) street canyon and park/stadium/square. It is demonstrated that the blockage effects produce an alternating renewal process with exponentially distributed non-blocked intervals, and blocked durations that follow the general distribution. The following metrics are derived (i) the mean and the fraction of time spent in blocked/non-blocked state, (ii) the residual blocked/non-blocked time, and (iii) the time-dependent conditional probability of having blockage/no blockage at time t1 given that there was blockage/no blockage at time t0. The latter is a function of the arrival rate (intensity), width, and height of moving blockers, distance to the mmWave access point (AP), as well as the heights of the AP and the user device. The proposed model can be used for system-level characterization of mmWave cellular communication systems. For example, the optimal height and the maximum coverage radius of the mmWave APs are derived, while satisfying the required mean data rate constraint. The system-level simulations corroborate that the use of the proposed method considerably reduces the modeling complexity.Comment: Accepted, IEEE Transactions on Vehicular Technolog

Learning and teaching approaches promoting resilience in student nurses: An integrated review of the literature.

Undergraduate nursing students face challenges that can result in stress leading to impaired performance, physical illness, high turnover and sickness absence (Kinman and Jones 2001). Students therefore require skills and knowledge to help them cope with the challenges of learning professional practice. This paper explores the concept of resilience, with an emphasis on how educational programmes can foster resilient practices among student nurses. Educators can facilitate resilience by incorporating resilience teaching and training that includes, the core concepts of resilience: self-efficacy, reflective ability and self-confidence. Critical appraisal and synthesis of the literature resulted in the identification of three themes: attributes, programmes and transition. The following five key learning and teaching methods were identified as supporting the development of resilience: peer activities; reflective practice; directed study; problem based learning/enquiry based learning and experiential learning Having resilience and resilient qualities is an integral part of nursing, having a positive impact upon the health and well-being of the nurse as practitioner. Resilient qualities and behaviours can be developed through the facilitation of appropriate learning and teaching interventions

Training healthcare professionals to be ready for practice in an era of social distancing: A realist evaluation

Background Programme changes due to the COVID-19 pandemic have impacted variably on preparation for practice of healthcare professional students. Explanations for such variability in outcomes between institutions and healthcare professions have yet to be explored. The aim of our study was to understand what clinical learning, whilst under socially distanced restrictions, worked and why (or why not). Methods We conducted a realist evaluation of the undergraduate healthcare programmes at one UK university in 2020-21. The initial programme theories to be tested in this study were derived from discussions with programme leads about the changes they implemented due to the pandemic. Study participants were students and teaching faculty. Online interview transcripts were coded, identifying why the interventions in the programme had worked or not. This resulted in a set of ‘context-mechanism-outcome’ (CMO) statements about each intervention. The initial programme theories were refined as a result. Results and discussion 29 students and 22 faculty members participated. 18 CMO configurations were identified relating to clinical skills learning and 25 relating to clinical placements. Clinical skills learning was successful whether in person, remote or hybrid if it followed the steps of: demonstration – explanation – mental rehearsal – attempt with feedback. Where it didn’t work there was usually a lack of observation and corrective feedback. Placements were generally highly valued despite gaps in experience. Being useful on placements was felt to be good preparation for practice. Participant explanations from junior students about the value of various modes of induction to clinical workplace activity may also be relevant post-pandemic

How the United Kingdom's Criminal Records Bureau can reduce the prevalence of elder abuse by improving recruitment decision-making

Specifically, organisations in both the private and public care sectors will be examined. Incidents reported by the media surrounding the failures in recruitment procedures will be discussed. An evaluation of recruitment decision-making will be carried out and details of the present study, which considers how recruitment decisions are being made at present by organisations in the National Health Service (NHS), social care (SC), higher education (HE), further education (FE) and care home (CH) sectors, will be reported. The first wave of data collection consisted of informal interviews carried out with a series of recruitment decision-makers from these organisations. Results showed that a variation in recruitment decision-making between organisations exists, and so the protection of vulnerable persons may be being put at risk

An Investigation of Individual Recruitment Decision−making following Criminal Records Bureau Checks: The Implications for the Protection of Vulnerable Adults.

In 2004 it was reported that up to half a million elderly people may be victims of abuse at any one time. Studies have shown that elder abuse can have devastating effects upon service users and can often lead to long-term health problems. It is vital that health care service providers acknowledge the importance of recruitment decision-making when employing carers for work involving vulnerable adults. In 2002 the Criminal Records Bureau (CRB) was established in the UK to ensure safer recruitment decisions could be made. The CRB check is utilised to facilitate safer recruitment decisions by providing employers with wider access to an applicant’s criminal record information through a Disclosure service. However, how these changes are impacting upon recruitment decisions and its implications for the protection of vulnerable adults is yet to be examined. Therefore, the research presented here, sets out to explore how recruitment decisions are being made by individual decision-makers using CRB Disclosure information. The implications of these decisions for the protection of vulnerable adults and the ex-offender are examined. Organisations from the National Health Service, Social Services, Higher Education, Further Education and Care Home sectors whose employees have contact with vulnerable persons were recruited to take part in this research. A mixed methods approach was utilised to investigate research objectives. The research objectives were as follows: 1. To analyse exactly who is responsible for making recruitment decisions in an organisation 2. To discover whether or not recruitment decisions are informed by any guidance 3. To assess what impact the knowledge of convictions has upon perceived suitability for employment of individuals working with vulnerable persons 4. To examine how trade off decisions for employment are made 5. To identify how easy or difficult recruitment decisions are to make 6. To examine the implications for the protection of vulnerable persons and 7. To evaluate the implications for human rights, civil liberties, discrimination and social exclusion. The findings indicate that recruitment decisions are being made inconsistently both within and between organisations. Both the actual recruitment decision made and the reasons for these decisions varied. In addition, results suggested that the organisation to which an ex-offender applies to for a post could determine the success of their application based on the recruitment decision-maker/s involved in the process. Moreover, there was no general consensus on what constituted a problematic offending profile. In order to aid data collection, a software package named Survey Software was created. This allowed the administration of a series of vignettes, whilst recording and sorting the inputted information